White matter hyperintensity shape in relation to long-term small vessel disease progression in community-dwelling older adults

White matter hyperintensity (WMH) shape was recently introduced as a novel small vessel disease (SVD) marker that may provide a more detailed characterization of WMH than volume alone. We aimed to investigate the association between baseline WMH shape and cerebrovascular disease progression over 5 years. A more irregular shape of periventricular/confluent and deep WMH at baseline is associated with increased progression of WMH volume. Moreover, a more irregular shape of periventricular/confluent WMH was associated with occurrence of new microbleeds and new subcortical infarcts at follow-up. Our findings indicate that a more irregular WMH shape is associated with SVD progression.